Presentation
A female patient from Southeast Asia with recurrent attacks of right upper quadrant pain and jaundice.
Patient Data
There are marked irregular intrahepatic biliary ductal dilatation in the right and left hepatic lobes most notably involving the right anterior and left medial hepatic segments. Innumerable intra-ductal different size filling defects calculi of low T2.
Proximal CBD is implicated with several calculi in its lumen (choledocholithiasis) is but the distal part of CBD is a normal caliber.
The gallbladder is folded, well distended and shows a homogenous signal and absence of gallbladder calculi.
The pancreatic duct is normal in course and caliber.
Reported by Dr Safwat Al Moghazi MD.
Case Discussion
A 35-year-old female from Southeast Asia presented to ER multiple times with RUQ abdominal pain, nausea, and fever. She was found to be septic. The patient has a history of obstructive jaundice.
Ultrasound revealed intrahepatic biliary duct dilation with multiple intra-hepatic biliary calculi. ERCP demonstrated similar findings.
The clinical history and imaging findings are consistent with recurrent pyogenic cholangitis, previously known as oriental cholangiohepatitis.
Case courtesy Dr Abdelhamed Elgargani MD.
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